Thursday, November 14, 2013

In
a press conference convened Thursday, November 14 at 1:30pm at the
State Capitol, Governor Walker addressed a room of advocates,
legislators, and media to announce that he is calling a special session
of the legislature to act on two bills that would: 1. Delay by 3 months
the termination of people from BadgerCare Plus above 100% FPL to allow
more time for people to select health care plans in the
Marketplace--that is, delay terminations until March 31; and 2. Delay by
3 months changes in HIRSP, the state's health insurance risk sharing
plan, originally set to sunset December 31, 2013. Walker expects the
Legislature to convene in late November. Walker stated, "It has become
abundantly clear that the rollout of ObamaCare is failing. We need to
take decisive action to make sure the people of the state don't fall
through the cracks."

In addition, Walker said he is asking Obama's administration to allow people to use subsidies to purchase any qualified plan, no matter where they purchase their plan--in or out of the Marketplace.

"Whether
you're for or against it, the roll-out of ObamaCare has not gone as
originally proposed...I'm not going to let the failures of the federal
government let people get caught between two systems." Walker clarified
that financially, "We don't need new GPR to do this." When answering
questions from the media about whether federal funds could have helped,
Walker added, "The failure of the ObamaCare rollout is the precise
reason I didn't take the Medicaid Expansion money in the first place."

Many
community leaders had recently pressured the Governor to delay the cuts
originally signed into law on June 30 in the Governor's most recent
budget. The state budget scheduled the termination of parents,
caretakers and adults from BadgerCare Plus on December 31. With delays
in the new Marketplace, due to poor functionality of healthcare.gov,
advocates and community leaders were skeptical that the estimated 80,000
individuals being terminated from BadgerCare Plus coverage would be
able to connect to the Marketplace by December 15, pick a plan, and pay
their first premium, in order to secure coverage that would start on
January 1, 2014 thus preventing a gap in coverage.

This
special session of lawmakers will convene before their next scheduled
meeting (January 14, 2014) with the hope that bills are voted on by
early December.Pressure to Extend the Deadline

Advocates
and community leaders have been calling on Governor Scott Walker to
defer cutting individuals off BadgerCare Plus if the federal marketplace
is not operational by the end of November. Open enrollment continues
through the end of March, but coverage can take up to several weeks
before kicking in after people sign up, which may result in penalties.
An advocacy letter
sent to Walker outlined concern for the 77,000 parents that may be out
of coverage stating, “These concerns are magnified by the healthcare.gov
technical glitches that have hindered enrollment thus far.” The letter
asked Walker to lay out his contingency plan if enrollment through the
exchange continues to present difficulties.

Milwaukee mayor, Tom Barrett, requested
that Walker delay these cutoffs, not to debate the integrity of the
Affordable Care Act or the changes to BadgerCare Plus in the last state
budget, but to ask Walker not to take insurance away from 92,000
individuals and families until the federal system is running smoothly.
Barrett wanted a three month delay in the BadgerCare cutoff.

And finally, in a letter dated November 12, U.S. Senator Tammy Baldwin
raised concerns about the plan to terminate parents and offered
solutions "to ensure our constituents maintain the health coverage they
need." Baldwin stated, "Your current outreach plan calls for residents
who will lose BadgerCare coverage to receive final notice at the end of
November, leaving them just two weeks to enroll or they will lose
coverage on January 1." Senator Baldwin also offers a number of
solutions that the Walker Administration could pursue, including
altering their current request to the Centers for Medicare &
Medicaid Services so that BadgerCare enrollees maintain their current
coverage through the end of March.

State Responsibility for How We Got HereRep. Sandy Pasch (D-Shorewood), too says there is state responsibility in this debacle. When speaking to the Shepherd's Express in Milwaukee, Pasch said Wisconsin had an opportunity to run its own exchange, and decided against it.

Wisconsin
decided against more than just that. When Walker took office in 2011,
he terminated former Governor Doyle's health reform efforts, transformed
the Office of Health Care Reform into the "Office of Free Market Health
Care" and then quickly closed it altogether, sent back exchange money,
set back Consumer Assistance Program Funds, and rejected a Medicaid
expansion. Wisconsin has been kicking and screaming against the law from
the start. Wisconsinites are probably feeling a little tired of the
opposition and angry at the obstacles to care and coverage.The
feds themselves will say they never anticipated that this many states
would refuse to participate in creating their own marketplaces, instead
pushing all their residents to the federal website. The volume, had
states participated, would have been manageable. "The feds at CMS who set up our Marketplace are not off the hook either," says ABC for Health's Bobby Peterson.
"They funded navigator programs in a hodge-podge way in Wisconsin and
set up a $400 million Rube Goldberg Machine to enroll in the
Marketplace." Cancelled Insurance Policies:

President
Obama held his own press conference today, easing complaints about
cancelled insurance policies. The administration announced it will let
health insurers extend existing health plans on the individual and small
group market into 2014, even if the plans do not meet regulations
imposed under the ACA. The only caveat is that insurers must "notify
consumers" of the protections these plans lack.

President
Obama was criticized for saying, "If you like your insurance, you can
keep it." What he was actually saying is "you can keep your plan, unless
your insurance company was offering such a terrible plan it could never
conform to consumer protection standards and fairness that it won't
comply with the law." Then the insurance company will most likely cancel
your plan. The consequence to today's decision is to allow
discriminatory plans to persist in the marketplace, in exchange for
offering insurance companies "more time" to adjust to new regulations.

Health
reform is not responsible for millions of Americans losing good health
insurance plans. Health reform is responsible for raising the standards
of coverage, and thus forcing the "junk health insurance" out of the marketplace. Consumer Reports
published a study of low cost, low coverage plans, placing them in
their own category of "junk." Their conclusion? No coverage is better
than junk coverage.

"These are insurance company decisions," says Bobby Peterson in an interview with Wisconsin Public Television's "Here and Now."
Plans made enough changes so that the plans are no longer eligible to
be "grandfathered." If the insurance companies wanted to maintain those
plans and enrollees, they could have done that.

We
also know the following to be true: This happens all the time in the
individual marketplace. BYU Professor of Political Science Richard Davis
in an opinion piece
to the Deseret News says, "They’ve been doing it for years to people
they didn’t want to cover. The difference is the news media didn’t tell
us about those cancellations."

Health
care consumers are better off when they have plans that don't
discriminate, even if that means some plans must disappear when they
don't meet basic, minimum standards. Davis says, "No longer will
consumers be left in a wild, wild west-style marketplace where insurers
can offer whatever they want and call it health care insurance."